Phoenix & York Ites Presentation


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Phoenix & York Ites Presentation

  1. 1. Phoenix & York Business Solutions Limited A VALUE DRIVEN SERVICE COMPANY THAT UNDERSTANDS BUSINESS Presentation Confidential - Copyright - Phoenix&York @2007
  2. 2. About Us • The IT and ITES Consulting arm is based at New York with Global delivery centre in Chennai, India • Backed by Industry Stalwarts & Experienced Top Management with very strong IT Industry credentials & huge experience curve in Servicing Fortune 1000 Clientele across the globe • Highly Qualified, Trained and Empowered Team • Process Capability, Maturity • Operational Efficiency & Optimized Productivity and customer-centric approach results in Repeat Business. • World Class Infrastructure with state of the art Security, Reliability • Service-Oriented Architecture (SOA) which ensures that global Clients SLA’s are met within the stringent deadlines. • Sustained Growth, satisfied Clientele • Systematic and Professional Approach backed by International Management Team • Flexible, Adaptive in Approach, Impeccable Delivery Mechanism and Personalized Service. Confidential - Copyright - Phoenix&York @2007
  3. 3. Service Model • Management Modes - Time and Materials (Customer Managed) - Turnkey (Phoenix & York Managed) - Hybrid (Onsite – Offshore ) • Pricing Modes - Time and Materials ( Effort Based ) - Fixed price ( Milestone Based ) - Fixed Transition Earnings • Our Models are - Flexible - Adaptable - Scalable - Open to Innovation Confidential - Copyright - Phoenix&York @2007
  4. 4. Services - ITES Medical Billing / Coding Demographics & Charge entry Audit Coding Insurance eligibility verification Claims transmission Cash posting Analysis Calling ( Insurance/Patient ) Month end reports Healthcare Insurance forms process Mail processing services preparatory to scanning Document scanning Offshore data entry with high quality output Archival & Storage Document management Scanning, imaging and indexing Systems and system support Data management Data preparation, capture and enhancement services Database building and management Confidential - Copyright - Phoenix&York @2007
  5. 5. Services - ITES Accounting / Financial Services Transaction entry Journal entry General ledger Assets / equipment ledgers Expenses ledger Accounts receivable services Accounts payable services Ageing report & summaries Payroll processing Bank account reconciliation Financial statements preparation Trial balance Income statement ( Profit/ & Loss ) Balance sheet Cash flow statement Audit Confidential - Copyright - Phoenix&York @2007
  6. 6. Medical Billing / Coding Demographics & Charge entry Our trained Medical Billing Professionals will enter personal information about the patient from the demographic sheet. The team will then check the relationship of the Diagnosis code with the CPT. A change will then be created according to the billing rules pertaining to specific carriers and locations. All charges will be accomplished within the turnaround time agreed with the client, which is generally 24 hours. Audit The daily charge entry will audited to check the accuracy of the entry based on carrier requirements to ascertain a clean claim. Coding Our Medical Coding service enables individuals and Hospitals to file a claim with the patient's health insurance provider, managed care organization, or government entities. Our These codes help medical insurance and others to understand what was wrong with the patient, whether treatment was necessary and what services were administered. All these codes help non-medical staff at the insurance company and other health service providers to handle the claims and make payments on a predetermined basis. Our specialty is ICD-9, CPT, HCPCS outpatient (physician) coding for the CMS-1500 /2000 form. Confidential - Copyright - Phoenix&York @2007
  7. 7. Medical Billing / Coding Claims transmission Claims will be filed and relevant information sent to the Transmission department. The operations team will then prepare a list of claims that are transmitted electronically. Once the claims are transmitted electronically, confirmation reports will be obtained and filed after verification. Paper claim will then be printed along with attachments and dispatched to insurance agencies. Finally, transmission rejections will be analyzed and appropriate corrective action will be taken. Cash posting The cash posting team will receive the copy of check and EOB. The team will then apply the payments in the billing software against appropriate patient account. During cash application, overpayments are immediately identified and refund requests are generated. The analysts will then be informed of underpayments and denials. Analysis Account receivable analysts will research the claims for completeness and accuracy. The AR analysts will then set orders about making calls from the call center. The analysts will also research denied claims, rejections received from clearing houses and low payments by carriers. After this research is completed appropriate action will be taken. Calling The call center executive will call the insurance agency and verify current status of the claim (whether it is being processed for payment or is being denied). Based on the claim status, the analyst will get the pre-requisites needed. If the claim is being processed for payment, a list of payment details will be compiled. If denied, corrective action will be initiated. Confidential - Copyright - Phoenix&York @2007
  8. 8. Medical Billing / Coding The Call Center Team will receive work orders from the analysts. The Call Center Executive will then initiate calls to the insurance companies to establish reasons for the non-payment of the claims. All such reasons will be passed on to the Analysts for resolution. Month End Reports At the end of the month, Phoenix & York will run procedure code usage reports and aged summary reports to asses what has been achieved for that particular month, and also to identify patterns of non payment if any. If any claim is found to be older than 60 days, immediate action will be taken. Any claims pending for clarification will be passed on to the respective account manager for remedial action. Insurance eligibility verification Patient Eligibility check is made online through Insurance websites to check benefits, Effective date of Policy etc. We also have a specialist Team that verifies Benefits by calling the Insurance companies This process would ensure cleaner claims being submitted to the appropriate Insurance companies. Confidential - Copyright - Phoenix&York @2007
  9. 9. Medical Billing / Coding Specialties Phoenix & York professional team, which is innately capable to ramp up in short notices, possesses a wide variety of skills and can perform variety of roles. Phoenix & York has experience in the following specialties. Family practice General practice Gynecology Internal medicine Neurology Nephrology Obstetrics Psychiatry Pulmonary diseases Radiology General surgery Physical therapist Pediatric Pain management Confidential - Copyright - Phoenix&York @2007
  10. 10. Medical Billing / Coding Account Receivables Phoenix & York can help in following up pending claims, initiating collections, tracing the reasons for claims denials, tracking outstanding receivable balances by customer and by the date when payment is due, providing periodic reports and more. The claims get denied mainly due to: Duplicate claim Additional information needed to process the claim Incorrect or missing CPT procedure code Physician’s name and/or UPIN missing or incorrect Incorrect or missing place of service code Phoenix & York can Reduce average days in accounts receivable Reduce write-offs from bad debt Reduce claim denials Improve your cash flow Increase your revenue by up to 40% Improve customer service and patient relations Confidential - Copyright - Phoenix&York @2007
  11. 11. Insurance Forms Process Phoenix & York offers end-to-end healthcare insurance administrative services. Phoenix & York provides Health Insurance Forms Processing services, from HCFA /CMS 1500, UB 92 and Dental forms in different formats. Our Services include: Mail processing services preparatory to scanning Document scanning Offshore Data entry with high quality output Archival & Storage Phoenix & York ensures 99% accuracy in data conversion to prevent payment errors down the line. Confidential - Copyright - Phoenix&York @2007
  12. 12. Insurance Forms Process - Diagram FTP Serv er Download folders Insuranc Convert into containing Scanned e Forms Electronic Format Images from the Client Scanning Local Serve r Distribute image to the Pro Asst Capture the required fields QC Confidential - Copyright - Phoenix&York @2007
  13. 13. Document management Document Management (Onshore): Phoenix & York can provide a range of services to manage the handling, sorting and preparing of paper, microfilm and microfiche prior to image conversion. The range of imaging services includes: • Image capture • Indexing • Optical storage • In-house or remote access and viewing • Multi-site and multi-user access and viewing • Image processing • Image retrieval • Interface to workflow or in-house systems • Provision of in-house managed services • Provision of document imaging systems. Confidential - Copyright - Phoenix&York @2007
  14. 14. Data management Data Management Services Capture and enhance The data capture services of Phoenix & York brings international resources and over several years of experience in the digitizing, processing and management of data. The company employees highly skilled specialists providing an aggregate capacity of over one billion key depressions per day. The services include: • Project specification • Document receipt and preparation • Manual editing and coding • Key from paper, microfilm, microfiche and image • Optical Marks Reading (OMR) • Optical Character Recognition (OCR) • Image Character Recognition (ICR) • Data output (to tape, disk, CD, mainframe or on-line) Database Management Capturing data to specific instructions alone does not always provide the end customer with the desired result to complete the process. Phoenix & York provides a range of Data Cleansing and Data Querying services to process keyed data. This service includes: • Offline validation of keyed information using external tables • Application processing with data irrigation and intelligent transcription • Database construction and migration using human intelligence • Database management Confidential - Copyright - Phoenix&York @2007
  15. 15. Accounting/Financial services Account/Financial/Bookkeeping Services Phoenix & York is a preferred supplier to many large financial services organizations providing value added services in supporting its back office operations. The company has made significant investment in people, process and technology to provide its customers with a suite of services in HR processing and back office accounting services. The company has a proven track record in handling: We have a very user friendly process in place. You can send your paper documents through an e-fax or by scanning & emailing it. Once we receive the scanned image of the document, it is filed in a document management system & the transaction is posted in the accounting software of your choice . We can update your books with in 24 hours Turn around time. This can be carried out by using QuickBooks back up. We upload the updated books on to a secure server. There are three options for using the Accounting package. • Using an ASP version. • We can host a server in our centre or a web form, with restricted access. • We could log in to your server & post the entries. Confidential - Copyright - Phoenix&York @2007
  16. 16. Accounting/Financial services Bookkeeping Services Includes Computerized processing of all checks and bookkeeping information. Bank statement reconciliation. Preparation and review of monthly financial statements. Maintenance of employee and sub-contractor earnings records. Preparation of all payroll related tax returns. Preparation of year-end W-2 and 1099 forms. Day-to-day bookkeeping and accounting. Books balanced and reconciled quarterly. Management accounts produced quarterly. VAT returns produced quarterly. Annual accounts and tax returns preparation. Submission to Inland Revenue. Submitted to Companies House. Expert tax advice to minimize tax liability. Adjustments to year-end accounts. Storage of documents at our offices Confidential - Copyright - Phoenix&York @2007
  17. 17. Advantage Phoenix & York Guaranteed • Measurable benefits • Cost savings • Guaranteed quality • Faster closure • Focus to grow the business • Better books, better profits • Security of your data • 100% accuracy of your data • 24/7 communication Confidential - Copyright - Phoenix&York @2007
  18. 18. Infrastructure Management Network Server OS & Applications Remote Desktop Mgmt Management Management Cisco Compliant Domain, Ftp, Production with Windows XP, Windows Vista, Daily Event Log, Routers, Leased Links, Server Rack, Windows 2003 MS Office & Image tool Patch Mgmt, Policy admin LAN & Firewall Server Environment Managed Security Services - Firewalls, IDS, Anti-Virus, Virus Scanning, Network Scan for Security etc Physical Security – Bio Metric Scan ID for All Employees, 24/7 Physical Security Service, Bio Metric Scan ID for All Server Rooms, CCTV, Fire Protection, E-Centrex Communication System for All Employees, Disaster Recovery offsite Center Confidential - Copyright - Phoenix&York @2007
  19. 19. Contact Details Global Delivery Centre Ispahani Center, 123/124, Nungambakkam High road, Chennai – 600034 Tel – 91 44 66141602/ 91 9940676954/ Fax: 91 44 66141602 Raja ruban ( Head of IT enabled Services Web: Confidential - Copyright - Phoenix&York @2007